Significance of Apparent Diffusion Coefficient for Pretreatment Prediction of Short-Term Treatment Effect of TACE for Hepatocellular Carcinoma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 ZHANGWei-wei ,  SONGBin , HUANGZi-xing , YUANFang , LIZheng-yan

Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China;

Corresponding author：

SONGBin, Email: cjr.songbin@vip.163.com

Keywords：

Hepatocellular carcinoma; Apparent diffusion coefficient; Transcatheter arterial chemoembolization

DOI：

10.7507/1007-9424.20150295

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the significance of apparent diffusion coefficient (ADC value) for pretrea-tment prediction of short-term treatment effect in patients with hepatocellular carcinoma (HCC) who underwent transca-theter arterial chemoembolization (TACE). Methods A total of twelve HCC patients with twenty-three HCC lesions who underwent TACE in our hospital from May. 2014 to May. 2015 were enrolled prospectively, to explore the difference between pre-and post-TACE in diameter of tumor, ADC value of HCC lesions, ADC value of liver parenchyma, and analyze the predictive significance of ADC value of HCC lesions for TACE in treatment of HCC. Results There were no statistical difference between pre-and post-TACE in diameter of HCC lesions and ADC value of liver parenchyma (P=0.635, P=0.473), but the ADC value of HCC lesions was higher after TACE than pre-TACE (P=0.003). After TACE, the area of necrosis in HCC lesions was≥50% in 17 lesions (73.9%, good effect group), and <50% in 6 lesions (26.1%, poor effect group). Compared with poor effect group, ADC values of HCC lesions in good effect group were both higher before and after TACE (P<0.050). Area under ROC curve (AUC value) of ADC value in HCC lesions before TACE for predicting the effect of TACE was 0.690 (95% CI:0.510-0.879), with the sensitivity and specificity of 82.3% (95% CI:65.5%-93.2%) and 53.8% (95% CI:25.1%-80.8%) respectively, and the demarcation point for good effect and poor effect was 1.24×10³ mm²/s. Conclusion This preliminary study demonstrates that the ADC value of HCC lesions before TACE may be a useful indicator to predict early response of TACE in treatment of HCC.

Citation： ZHANGWei-wei, SONGBin, HUANGZi-xing, YUANFang, LIZheng-yan. Significance of Apparent Diffusion Coefficient for Pretreatment Prediction of Short-Term Treatment Effect of TACE for Hepatocellular Carcinoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(9): 1133-1136. doi: 10.7507/1007-9424.20150295 Copy

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25.	陈炳, 赵振华, 杨建峰, 等. 肝细胞癌磁共振扩散加权成像与肿瘤细胞密度及微血管密度的相关性研究. 肿瘤学杂志, 2015, 21(5):440-442.

1. Bruix J, Sala M, Llovet JM. Chemoembolization for hepatocellular carcinoma. Gastroenterology, 2004, 127(5 Suppl 1):S179-S188.
2. Kamel IR, Bluemke DA, Eng J, et al. The role of functional MR ima-ging in the assessment of tumor response after chemoembolization in patients with hepatocellular carcinoma. J Vasc Interv Radiol, 2006, 17(3):505-512.
3. Kamel IR, Bluemke DA, Ramsey D, et al. Role of diffusion-weighted imaging in estimating tumor necrosis after chemoembolization of hepatocellular carcinoma. AJR Am J Roentgenol, 2003, 181(3):708-710.
4. Kamel IR, Reyes DK, Liapi E, et al. Functional MR imaging assess-ment of tumor response after ⁹⁰Y microsphere treatment in patients with unresectable hepatocellular carcinoma. J Vasc Interv Radiol, 2007, 18(1 Pt 1):49-56.
5. Chen CY, Li CW, Kuo YT, et al. Early response of hepatocellular carcinoma to transcatheter arterial chemoembolization:choline levels and MR diffusion constants-initial experience. Radiology, 2006, 239(2):448-456.
6. Deng J, Miller FH, Rhee TK, et al. Diffusion-weighted MR imaging for determination of hepatocellular carcinoma response to yttrium-90 radioembolization. J Vasc Interv Radiol, 2006, 17(7):1195-1200.
7. Mannelli L, Kim S, Hajdu CH, et al. Assessment of tumor necrosis of hepatocellular carcinoma after chemoembolization:diffusion-weighted and contrast-enhanced MRI with histopathologic correla-tion of the explanted liver. AJR Am J Roentgenol, 2009, 193(4):1044-1052.
8. 中华人民共和国卫生部. 原发性肝癌诊疗规范(2011年版). 临床肝胆病杂志, 2011, 27(11):1141-1159.
9. Mannelli L, Kim S, Hajdu CH, et al. Serial diffusion-weighted MRI in patients with hepatocellular carcinoma:prediction and assessment of response to transarterial chemoembolization. Preliminary experience. Eur J Radiol, 2013, 82(4):577-582.
10. Llovet JM, Ricci S, Mazzaferro V, et al. Sorafenib in advanced hepatocellular carcinoma. N Engl J Med, 2008, 359(4):378-390.
11. Eisenhauer EA, Therasse P, Bogaerts J, et al. New response evalua-tion criteria in solid tumours:revised RECIST guideline (version 1.1). Eur J Cancer, 2009, 45(2):228-247.
12. Kamel IR, Liapi E, Reyes DK, et al. Unresectable hepatocellular carcinoma:serial early vascular and cellular changes after transar-terial chemoembolization as detected with MR imaging. Radiology, 2009, 250(2):466-473.
13. Kim H, Morgan DE, Buchsbaum DJ, et al. Early therapy evaluation of combined anti-death receptor 5 antibody and gemcitabine in orthotopic pancreatic tumor xenografts by diffusion-weighted magnetic resonance imaging. Cancer Res, 2008, 68(20):8369-8376.
14. Kim H, Morgan DE, Zeng H, et al. Breast tumor xenografts:diffusion-weighted MR imaging to assess early therapy with novel apoptosis-inducing anti-DR5 antibody. Radiology, 2008, 248(3):844-851.
15. Dong S, Ye XD, Yuan Z, et al. Relationship of apparent diffusion coefficient to survival for patients with unresectable primary hepato-cellular carcinoma after chemoembolization. Eur J Radiol, 2012, 81 (3):472-477.
16. Yuan Z, Ye XD, Dong S, et al. Role of magnetic resonance diffusion-weighted imaging in evaluating response after chemoembolization of hepatocellular carcinoma. Eur J Radiol, 2010, 75(1):e9-e14.
17. 金征宇, 薛华丹. 全身弥散加权成像肿瘤学临床应用图谱. 北京:科学出版社, 2009:2-3.
18. Hamstra DA, Lee KC, Tychewicz JM, et al. The use of 19F spectros-copy and diffusion-weighted MRI to evaluate differences in gene-dependent enzyme prodrug therapies. Mol Ther, 2004, 10(5):916-928.
19. Koh DM, Scurr E, Collins D, et al. Predicting response of colorectal hepatic metastasis:value of pretreatment apparent diffusion coeffi-cients. AJR Am J Roentgenol, 2007, 188(4):1001-1008.
20. Cui Y, Zhang XP, Sun YS, et al. Apparent diffusion coefficient:potential imaging biomarker for prediction and early detection of response to chemotherapy in hepatic metastases. Radiology, 2008, 248(3):894-900.
21. Kono K, Inoue Y, Nakayama K, et al. The role of diffusion-weighted imaging in patients with brain tumors. AJNR Am J Neuroradiol, 2001, 22(6):1081-1088.
22. Guo AC, Cummings TJ, Dash RC, et al. Lymphomas and high-grade astrocytomas:comparison of water diffusibility and histologic characteristics. Radiology, 2002, 224(1):177-183.
23. Ellingson BM, Malkin MG, Rand SD, et al. Validation of functional diffusion maps (fDMs) as a biomarker for human glioma cellularity. J Magn Reson Imaging, 2010, 31(3):538-548.
24. 莫蕾, 江新青, 陈阿梅, 等. DWI对宫颈癌的诊断及与肿瘤细胞密度相关性的初步研究. 中国CT和MRI杂志, 2011, 9(3):49-52.
25. 陈炳, 赵振华, 杨建峰, 等. 肝细胞癌磁共振扩散加权成像与肿瘤细胞密度及微血管密度的相关性研究. 肿瘤学杂志, 2015, 21(5):440-442.

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Significance of Apparent Diffusion Coefficient for Pretreatment Prediction of Short-Term Treatment Effect of TACE for Hepatocellular Carcinoma

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